title: Depression and glycemic intake in the homebound elderly.
abstract: BACKGROUND
  Depression is associated with an increase in the incidence of type 2 diabetes, but the mechanism is unclear. We aimed to study the relationship between depression and glycemic intake in the elderly, and examine whether antidepressant use modified this relationship.
  
  
  METHODS
  We evaluated 976 homebound elders in a cross-sectional study. Depression was defined by having a Center for Epidemiological Studies Depression (CES-D) score ≥16. Antidepressant use was documented. Glycemic index (GI), Glycemic load (GL), and fasting blood insulin levels were measured.
  
  
  RESULTS
  Depressed elders had slightly higher GI (Mean±SD: 55.8±3.8 vs. 55.1±3.7, P=0.003) and higher insulin levels (Median: 84.0 vs. 74.4pmol/ml, P=0.05) than non-depressed elders. Depressed elders receiving antidepressants, primarily selective serotonin reuptake inhibitors (SSRI), had lower GI (Mean±SD: 55.1±4.7 vs. 56.2±3.4, P=0.002) and GL (Median: 170.3 vs. 6826.3, P=0.03) than those not taking antidepressants. After adjusting for potential confounding variables, GI remained positively associated with depression (β=+0.65, SE=0.28, P=0.02); the logarithm of GL was positively associated with depression (β=+0.33, SE=0.17, P=0.05) and negatively associated with antidepressant use (β=-0.54, SE=0.18, P=0.003).
  
  
  CONCLUSIONS
  Prospective studies are needed to examine whether high glycemic intake is a mediating factor between late life depression and the risk of type 2 diabetes.
authors.affiliation: Department of Public Health and Family Medicine, Tufts University, United States.
authors.forename: D Mkaya
authors.initials: DM
authors.lastname: Mwamburi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Liebson
authors.forename: Marshal
authors.initials: M
authors.lastname: Folstein
authors.forename: Kathleen
authors.initials: K
authors.lastname: Bungay
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Tucker
authors.forename: Wei Qiao
authors.initials: WQ
authors.lastname: Qiu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000453:epidemiology / Q000523:psychology*; D004040:Dietary Carbohydrates / Q000008:administration & dosage* / Q000378:metabolism; D005247:Feeding Behavior; D005260:Female; D038321:Glycemic Index; D018577:Homebound Persons / Q000523:psychology*; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D015999:Multivariate Analysis; D012016:Reference Values; D012307:Risk Factors; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013223:Statistics as Topic
chemical_list: D000928:Antidepressive Agents; D001786:Blood Glucose; D004040:Dietary Carbohydrates; D007328:Insulin; D017367:Selective Serotonin Reuptake Inhibitors